Individual
MR. REGINALD LAMONT WILLIAMSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
12923 S PARNELL AVE, CHICAGO, IL 60628-7442
(773) 405-8996
(773) 468-7918
Mailing address
12923 S PARNELL AVE, CHICAGO, IL 60628-7442
(773) 405-8996
(773) 468-7918
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
W45273274015
IL
Other
Enumeration date
12/14/2015
Last updated
12/14/2015
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